Cs-analyst, QA

2 weeks ago

New York, United States MultiPlan Inc. Full time

Imagine a workplace that encourages you to interpret, innovate and inspire. Our employees do just that by helping healthcare payers manage the cost of care, improve competitiveness and **inspire** positive change. You can be part of an established company with a 40-year legacy that helps our customers thrive by **interpreting** our client's needs and tailoring **innovative** healthcare cost management solutions.

Our commitment to diversity, inclusion and belonging are part of the fabric of our company. We strive to create a workplace that fosters mutual respect and collaboration, where every talent individual can participate and perform their best work. We are MultiPlan and we are where bright people come to shine

JOB SUMMARY:
This position administers routine daily and weekly audits of work performed in various operational areas to ensure continual adherence to defined business processes and procedures. The driven, results-oriented incumbent will work to identify defects, issues and/or trends present in new and existing processes while working to identify "root cause" of all defects incurred.

JOB ROLES AND RESPONSIBILITIES:
1. Administer assigned daily and weekly audits in a consistent and timely manner while ensuring continual compliance with department policies.
3. Draft and deliver timely, consistent, and systematically detailed audit result summaries on a weekly and on-going basis that maintain compliance with department and business area processes and procedures. Ensure audit documentation concisely describes and substantiates audit findings, and also addresses expected course of action to assure efficient disposition of defects.
4. Develop and maintain domain expertise of business rules specific to the assigned area of audit. Partner with business process owners to develop and maintain a complete understanding of business area process goals and intent.
5. Proactively and continually seek opportunities to increase knowledge and understanding. Learn from experience, others, mistakes and challenges. Ask questions to ensure conceptual understanding of processes and priorities.
7. Meet all applicable audit deadlines and ensure audits are completed within expected turn-around time (TAT's)
8. Ensure department performance and production standards are maintained through consistent achievement of departmental goals.
9. Ensure systematic data oriented efforts to improve consumer and/or client services are continually maintained. 95% of this job is related to QM activities
10. Collaborate, coordinate, and communicate across disciplines and departments
11. Attend team meetings and openly participate in discussions regarding operational procedures and quality updates.
12. Ensure compliance with HIPAA regulations and requirements.
13. Demonstrate commitment to the Company's core values.
14. Please note due to the exposure of PHI sensitive data, this role is considered to be a High Risk Role.
15. Responsible for routine internal monitoring and auditing of compliance risks, prompt response to compliance issues as they are raised, investigation of potential compliance problems as identified in the course of self-evaluation and audits, correction of such problems promptly and thoroughly to reduce the potential for recurrence as required by applicable state and federal laws, regulations and MPI's Compliance Programs
16. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB REQUIREMENTS (Education, Experience, and Training):

- Minimum High School Diploma or GED and 2 years related experience; Associates degree preferred.
- Previous managed healthcare experience preferred
- Knowledge of rules, policies and procedures related to QA audit process and area of audit
- Strong communication (written, verbal, listening) and analytical skills
- Ability to use software, hardware and peripherals related to job responsibilities including MS Office Suites, Word, Excel, Outlook, etc.
- Ability to be systematically detail oriented
- Ability to maintain a grasp on business and departmental process rules
- Ability to produce quality work while meeting production goals
- Ability to understand and be able to convey department goals, guidelines, and processes
- Ability to understand and quickly adapt to new processes and procedures.
- Ability to work in a self-directed, results oriented environment.
- Ability to adapt quickly to a fast-paced changing environment.
- Ability to utilize data and draw sound, logical conclusions.
- Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone

**BENEFITS**

We realize that our employees are instrumental to our success, and we reward them accordingly with ver

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